Method and apparatus for providing contraction information during labour

ABSTRACT

A system and apparatus for implementing a user interface for displaying uterine contraction information is provided. The graphical user interface displays first information conveying a rate of uterine contractions, the first information being derived at least in part on the basis of at least a portion of a contraction signal. The graphical user interface also displays, concurrently with the first information, second information conveying a threshold rate of uterine contractions. In specific examples of implementation, the graphical user interface is adapted for selectively causing an alarm event based at least in part on a rate of uterine contractions conveyed by the first information and the threshold rate of uterine contractions.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is a continuation-in-part of previously filed U.S.application entitled “METHOD AND APPARATUS FOR DISPLAYING LABOUR RELATEDINFORMATION ASSOCIATED TO AN OBSTETRICS PATIENT” filed on May 1, 2006 byEmily Hamilton and which was assigned Ser. No. 11/416,281. The contentsof the above application are incorporated herein by reference.

FIELD OF THE INVENTION

The present invention relates generally to the field of obstetrics and,more specifically, to a method and apparatus for monitoring laborprogression and for providing a user interface to display data conveyingmaternal information during labor.

BACKGROUND

Uterine contractions are intermittent and co-ordinated tightenings ofthe uterine muscle. Uterine contractions provide the force that makeslabour progress, by causing the baby to descend through the birth canaland making the cervix efface (shorten), and dilate (open). This force isrelated to the frequency, strength and duration of the contractions.Oxytocin is a natural hormone that causes uterine contractions. Asynthetic version of oxytocin is often administered during labour toincrease the frequency, duration and strength of uterine contractions orto induce labour. The medication is administered through a continuousintravenous infusion. There is no fixed dosage as in antibiotic therapy;rather the dose is adjusted frequently according to the patient'sresponse to achieve the desired frequency and intensity of contractions.

When the uterine muscle contracts, the maternal blood vessels in it areconstricted causing a temporary reduction in the blood flow and deliveryof oxygen to the baby's placenta. Relaxation of the contraction restoresthe flow and oxygen delivery to the baby. In normal circumstances,babies tolerate contractions well. However, in other circumstances, suchas when the placenta malfunctions or the contractions are excessivelyfrequent with little or no relaxation time between them, the baby maynot tolerate this reduction in oxygen delivery. If the situation remainsuncorrected or worsens it may result in injury to the baby's brain andpermanent disability.

At present, clinical staff estimates the frequency of contractions byfeeling the mother's abdomen for a few minutes and noting the timing ofa few contractions or by examining a paper tracing that shows arecording of contraction pressures/intensity over time. Theseassessments are performed periodically and the results recorded in themedical record.

A deficiency with the above-described methods for assessing contractionfrequency is that they are prone to inaccuracy and incompletenessbecause they are visual estimates based on short selected segments ofthe tracing and the caregiver may fail to make assessments at theprescribed time intervals and may fail to appreciate the degree andduration of the abnormality as well as the response of the baby. Thus,there can be a delay or failure to recognize overly frequentcontractions, to adjust the medication correctly, resulting in aniatrogenic injury to the baby.

In the context of the above, there is a need to provide a method anddevice for monitoring contractions for an obstetrics patient thatalleviates at least in part problems associated with the existingmethods and devices.

SUMMARY OF THE INVENTION

In accordance with a first broad aspect, the invention provides acomputer readable storage medium storing a program element suitable forexecution by a CPU where the program element implements a graphical userinterface module for displaying uterine contraction information. Thegraphical user interface module is adapted for receiving a contractionsignal conveying information related to occurrences of uterinecontractions over time. The graphical user interface module is adaptedfor displaying first information conveying a rate of uterinecontractions, the first information being derived at least in part onthe basis of at least a portion of the contraction signal. The graphicaluser interface module is also adapted for displaying, concurrently withthe first information, second information conveying a threshold rate ofuterine contractions. The graphical user interface module is alsoadapted selectively causing an alarm event based at least in part on arate of uterine contractions conveyed by the first information and thethreshold rate of uterine contractions.

An advantage of the present invention is that it allows clinical staffmaking use of the graphical user interface module to readily trackcontraction rates and be provided with an indication, through thedisplay of the threshold rate of uterine contractions, of a boundarydefining safe care. As such, the clinical staff is enabled to moreeasily assess labour progress. More specifically, the display of thegraphical user interface module allows the clinical staff to readilyascertain when the contraction rate falls outside a limit set by thethreshold rate of uterine contractions and, therefore, allows theclinical staff to take the necessary action in response to theoccurrence of this event. In specific practical implementation, thethreshold rate of uterine contractions will be set by hospital policyand/or on the basis of recognized best practices. The graphical userinterface module also provides an improved method for alerting the staffto conditions requiring intervention by causing an alarm event.

In accordance with specific examples of implementation, the graphicaluser interface module may cause an alarm event in response to a rate ofuterine contractions conveyed by the first information falling outside alimit set by the threshold rate of uterine contractions. Alternatively,the graphical user interface module may cause an alarm event in responseto a rate of uterine contractions conveyed by the first informationexceeding the threshold rate of uterine contractions. Alternatively, thegraphical user interface module may cause an alarm event in response toa rate of uterine contractions conveyed by the first information fallingoutside a limit set by the threshold rate of uterine contractions for atime duration exceeding a predetermined time duration. Advantageously,this second alternative allows the graphical user interface module totake into account a prolonged duration of an anomalous contraction ratewhen causing an alarm event.

In accordance with specific examples of implementation, the graphicaluser interface module receives contraction medication informationconveying information associated to administration of contractioninducing medication to the obstetrics patient. The contractionmedication information may indicate whether contraction-inducingmedication was administered and, optionally, a dosage of the contractioninducing medication administered. The graphical user interface moduleselectively causes an alarm event based at least in part on a rate ofuterine contractions conveyed by the first information, on the thresholdrate of uterine contractions and on the contraction medicationinformation.

Advantageously, this alternative implementation allows the graphicaluser interface module to take into account whether contraction inducingmedication was administered to the obstetrics patient being monitored(and optionally the amount of contraction inducing medication which wasadministered) when causing an alarm event.

In accordance with another specific examples of implementation, thegraphical user interface module receives fetal heart rate information.The graphical user interface module selectively causes an alarm eventbased at least in part on a rate of uterine contractions conveyed by thefirst information, on the threshold rate of uterine contractions and onthe fetal heart rate information. The fetal heart rate information mayincluding a fetal heart rate signal or, alternatively, may includeinformation conveying a level of risk associated with the fetus, thelevel of risk being derived on the basis of a fetal heart rate signal.Where the fetal heart rate information includes a fetal heart ratesignal, the graphical user interface module is adapted for processingthe signal to determine a level of risk associated with the fetal heartrate signal. Any suitable method for assessing a level of risk on thebasis of a fetal heart rate signal may be used. For example, the levelof risk may be based on the frequency of the fetal heart rate, whetherit is too high or too low for a certain period of time. Alternatively,the level of risk may be based on other suitable known methods. Anon-limiting example of a method for providing an indication of thelevel of risk is described in U.S. Pat. No. 7,113,819, entitled “Methodand apparatus for monitoring the condition of a fetus”, issued on Sep.26, 2006 to E. Hamilton et al. and assigned to LMS Medical Systems Ltd.The contents of this document are incorporated herein by reference.Other suitable methods for assessing a level of risk on the basis of afetal heart rate signal may be used without detracting from the spiritof the invention.

Advantageously, the above-described alternative implementation allowsthe graphical user interface module to take into account the behaviourof the fetal heart rate, and therefore the response of the baby, incombination with the contraction rate when causing an alarm event.

In accordance with another specific examples of implementation, thegraphical user interface module receives fetal heart rate informationand contraction medication information. The graphical user interfacemodule selectively causes an alarm event based at least in part on arate of uterine contractions conveyed by the first information, on thethreshold rate of uterine contractions, on the fetal heart rateinformation and on the contraction medication information.

In accordance with specific examples of implementation, the alarm eventmay include displaying a visual indicator, causing an audio signal to beissued and/or causing a message signal to be transmitted to a remotedevice. The remote device may be any device suitable for conveyinginformation to its user. Examples of remote devices include, withoutbeing limited to, PDAs, telephones, pager and computing terminals.

In accordance with a first specific example of implementation, the firstinformation includes a first tracing conveying rates of uterinecontractions over time and the second information includes a secondtracing conveying the threshold rate of uterine contractions. The firsttracing and the second tracing are displayed in a same viewing window.

Advantageously, the first and second tracings displayed a same viewingwindow allow the clinical staff to readily ascertain the contractionrate and variations thereof over an extended time period. This allowsthe clinical staff to more easily distinguish between short-termvariations in contraction rate, which could signal innocuous transientstates and long term persistence and trends in the contraction rate. Inaddition, this allows the clinical staff to have a more complete view ofthe history of the contraction rate since labour onset, or at leastsince the clinical staff was monitoring the labour. For example, thisallows determining whether the contraction rate is consistently abovethe threshold rate or whether it was merely a temporary increase incontraction rate and was induced either through the administration ofmedication or other method.

In accordance with a specific implementation, the graphical userinterface module is operative for processing the contraction signal toderive a set of contraction rate data elements, each contraction ratedata element being associated to a segment of the contraction signal.The graphical user interface module causes an alarm event in response toat least one contraction rate data element in the set of contractionrate data elements falling outside a limit set by the threshold rate.

In accordance with a second specific example of implementation, thefirst information and the second information include alphanumericcharacters for conveying rates of uterine contractions over time and athreshold rate of uterine contractions.

In accordance with another broad aspect, the invention provides a methodfor displaying uterine contraction information. The method comprisesreceiving a contraction signal conveying information related tooccurrences of uterine contractions over time. The method also comprisesdisplaying first information conveying a rate of uterine contractions,the first information being derived at least in part on the basis of atleast a portion of the contraction signal. The method also comprisesdisplaying, concurrently with the first information, second informationconveying a threshold rate of uterine contractions. The method alsocomprises selectively causing an alarm event based at least in part on arate of uterine contractions conveyed by the first information and thethreshold rate of uterine contractions.

In accordance with another broad aspect, the invention provides anapparatus for displaying uterine contraction information in accordancewith the above-described method.

In accordance with another broad aspect, the invention provides a labourmonitoring system. The system includes a sensor for receivinginformation indicative of occurrences of uterine contractions over time.The system also includes an apparatus for implementing a user interfacefor displaying uterine contraction information. The apparatus comprisesan input in communication with the sensor for receiving a contractionsignal conveying information related to occurrences of uterinecontractions over time. The apparatus also comprises a processing unitin communication with the input. The processing unit implements agraphical user interface module for displaying uterine contractioninformation. The graphical user interface module is adapted fordisplaying first information conveying a rate of uterine contractions,the first information being derived at least in part on the basis of atleast a portion of the contraction signal. The graphical user interfacemodule is also adapted for displaying, concurrently with the firstinformation, second information conveying a threshold rate of uterinecontractions. The graphical user interface module is also adapted forselectively causing an alarm event based at least in part on a rate ofuterine contractions conveyed by the first information and the thresholdrate of uterine contractions. The apparatus includes an output incommunication with the processing unit for releasing a signal forcausing a display unit to display the graphical user interface module.The system also includes a display unit in communication with the outputof the apparatus. The display unit is responsive to the signal releasingby the output of the apparatus to display the graphical user interfacemodule.

In accordance with yet another broad aspect, the invention provides aserver system implementing a graphical user interface module fordisplaying uterine contraction information. The server system stores aprogram element for execution by a CPU. The program element includes aplurality of program element components. A first program elementcomponent is for receiving a contraction signal conveying informationrelated to occurrences of uterine contractions over time. A secondprogram element component is for processing the contraction signal andissue a signal for displaying:

-   -   first information conveying a rate of uterine contractions, the        first information being derived at least in part on the basis of        at least a portion of the contraction signal; and    -   displaying, concurrently with the first information, second        information conveying a threshold rate of uterine contractions;

A third program element component is for selectively causing an alarmevent based at least in part on a rate of uterine contractions conveyedby the first information and the threshold rate of uterine contractions.

In accordance with yet another broad aspect, the invention provides aclient-server system for implementing a graphical user interface modulefor displaying uterine contraction information. The client-server systemcomprises a client system and a server system operative to exchangemessages over a data network. The server system stores a program elementfor execution by a CPU. The program element includes a plurality ofprogram element components. A first program element component is forexecution on the server system and is for receiving a contraction signalconveying information related to occurrences of uterine contractionsover time. A second program element component is for execution on theserver system and is for sending messages to the client system forcausing the client system to:

-   -   i) display first information conveying a rate of uterine        contractions, the first information being derived at least in        part on the basis of at least a portion of the contraction        signal; and    -   ii) display, concurrently with the first information, second        information conveying a threshold rate of uterine contractions.

A third program element component is for execution on the server systemand is for selectively sending messages to the client system for causingan alarm event based at least in part on a rate of uterine contractionsconveyed by the first information and the threshold rate of uterinecontractions.

In a specific implementation, the client-server system includes aplurality of client systems operative to exchange messages with theserver system over a data network. The data network may be of anysuitable network configuration including Intranets and the Internet.

In accordance with another broad aspect, the invention provides anapparatus for implementing a user interface for displaying uterinecontraction information. The apparatus comprises means for receiving acontraction signal conveying information related to occurrences ofuterine contractions over time and means for implementing a graphicaluser interface module for displaying uterine contraction information.The graphical user interface module is adapted for displaying firstinformation conveying a rate of uterine contractions, the firstinformation being derived at least in part on the basis of at least aportion of the contraction signal. The graphical user interface moduleis also adapted for displaying concurrently with the first information,second information conveying a threshold rate of uterine contractions.The graphical user interface module is also adapted for selectivelycausing an alarm event based at least in part on a rate of uterinecontractions conveyed by the first information and the threshold rate ofuterine contractions. The apparatus also includes means for releasing asignal for causing a display unit to display the graphical userinterface module.

In accordance with yet another broad aspect, the invention provides amethod for displaying uterine contraction information. The methodcomprises transmitting to a remote computing unit a contraction signalconveying information related to occurrences of uterine contractionsover time. The method also comprises receiving first informationconveying a rate of uterine contractions, the first informationcorresponding to at least a portion of the contraction signal. Themethod also comprises displaying a graphical user interface conveyingthe first information and a threshold rate of uterine contractions. Themethod also comprises receiving a signal suitable for causing an alarmevent based at least in part on a rate of uterine contractions conveyedby the first information and the threshold rate of uterine contractions.

In accordance with another broad aspect, the invention provides acomputer readable storage medium storing a program element suitable forexecution by a CPU, the program element implementing a graphical userinterface module for displaying uterine contraction information. Thegraphical user interface module is adapted for receiving a contractionsignal conveying information related to uterine contractions over time.The graphical user interface module is also adapted for processing thecontraction signal to derive first information conveying rates ofuterine contractions over time and for displaying the first informationin a viewing window. The graphical user interface module is also adaptedfor displaying concurrently with the first information, secondinformation conveying a threshold rate of uterine contractions.

These and other aspects and features of the present invention will nowbecome apparent to those of ordinary skill in the art upon review of thefollowing description of specific embodiments of the invention inconjunction with the accompanying drawings.

BRIEF DESCRIPTION OF THE DRAWINGS

In the accompanying drawings:

FIG. 1 shows a high-level functional block diagram of a labourmonitoring system implementing a user interface for displaying uterinecontraction information in accordance with a specific example ofimplementation of the present invention;

FIG. 2 is a functional block diagram of an apparatus implementing a userinterface for displaying uterine contraction information in accordancewith a specific example of implementation of the present invention;

FIG. 3 shows a specific example of implementation of a graphical userinterface implemented by the system shown in FIG. 1 for displayinguterine contraction information in accordance with a specific example ofimplementation of the invention;

FIGS. 4a and 4b show an alternative specific example of implementationof a graphical user interface implemented by the system shown in FIG. 1for displaying uterine contraction information in accordance with analternative specific example of implementation of the invention;

FIG. 5 shows another alternative specific example of implementation of avariant of the graphical user interface implemented by the system shownin FIG. 1 for displaying uterine contraction information in accordancewith another specific example of implementation of the invention;

FIGS. 6a and 6b are flow diagrams of a process for displaying uterinecontraction information in accordance with a specific example ofimplementation of the present invention;

FIGS. 7a and 7b are graphical representations of contraction signals inaccordance with non-limiting examples of implementation of the presentinvention;

FIG. 8 is a block diagram of an apparatus for providing uterinecontraction information in accordance with a specific example ofimplementation of the present invention;

FIG. 9 is a high level conceptual block diagram of a program element forimplementing a graphical user interface of the type shown in either oneof FIGS. 3, 4 a, 4 b and 5 in accordance with a specific example ofimplementation of the present invention;

FIG. 10 shows a functional block diagram of a client-server system forproviding uterine contraction information in accordance in accordancewith an alternative specific non-limiting example of implementation ofthe present invention.

Other aspects and features of the present invention will become apparentto those ordinarily skilled in the art upon review of the followingdescription of specific embodiments of the invention in conjunction withthe accompanying figures.

DETAILED DESCRIPTION

With reference to FIG. 1, there is shown a configuration of a labourmonitoring system 150 comprising a uterine activity sensor 120, a userinput device 118, an apparatus 100 implementing a user interface fordisplaying uterine contraction information and a display unit 114.

In accordance with a specific implementation, the sensor 120 formonitoring uterine activity samples the contraction pattern at a certainpre-determined frequency to generate a signal indicative of uterineactivity. The resulting signal, herein referred to as a contractionsignal, conveys information related to the occurrence of uterinecontractions over time. More specifically, the contraction signalconveys information on the occurrence of contraction events. Broadlystated, a contraction event refers to a continuous time period duringwhich the uterine muscle of an obstetrics patient is tightening. Duringlabour, contraction events are interleaved with relaxation periodsduring which the uterine muscle ceases to contract or contracts to alesser extent. The contraction signal may be a continuous signalconveying contraction intensity information or may be comprised ofunitary signal events where a signal event is generated when acontraction event is detected. Typically, when the contraction signal iscomprised of unitary signal events, a signal event is generated when theonset of a contraction event is detected. Sensors for monitoring uterineactivity are well known in the art to which this invention pertains andany suitable sensor may be used without detracting from the spirit ofthe invention and as such will not be described further here.

Alternatively, certain embodiments of the labour monitoring system 150may omit the sensor 120 and instead make use of a user-controlled inputfor generating the contraction signal. The user-controlled input allowsa user to provide over time information signalling the onset of acontraction event such as to convey information associated tocontraction activity over time. Such a user-controlled input may be inthe form of a manually controlled actuator that can be activated bydepressing a button when the obstetrics patient senses the onset of acontraction or in any other suitable configuration allowing a user tosignal the onset of contraction events over time. Although the usercontrolling the actuator may be the expectant mother, it will mostlikely be a person other than the expectant mother, such as theexpectant father or a nurse for example, since the expectant mother willmost likely have other concerns during labour. In such an alternativeembodiment, the contraction signal is comprised of unitary signalevents. It will be readily appreciated that such a configuration may besomewhat inconvenient in practice since it would require that the userdiligently enter contraction information. Consequently, although thisalternative implementation has been presented for the purpose ofcompleteness and as an alternative example of implementation, it will bereadily appreciated that using a sensor 120 for monitoring uterineactivity will be preferred in practical implementations of theinvention.

The apparatus 100 is for implementing a graphical user interface modulefor displaying uterine contraction information. The graphical userinterface module displays first information conveying a rate of uterinecontractions derived at least in part on the basis of at least a portionof the contraction signal. The graphical user interface module alsodisplays, concurrently with the first information, second informationconveying a threshold rate of uterine contractions. The graphical userinterface module selectively causes an alarm event based at least inpart on a rate of uterine contractions conveyed by the first informationand the threshold rate of uterine contractions. The apparatus 100 alsoreleases a signal for causing the display unit 114 to display thegraphical user interface module. Optionally, the apparatus is furtheradapted for releasing signals to a data output module 130 for causingthe latter to convey information associated to labour progression to auser of the labour monitoring system 150. Specific examples ofimplementation of the apparatus 100 and of the graphical user interfacemodule will be described later on in the specification.

The user input device 118 is for receiving data from a user of thesystem. The user input device 118 may be used, for example, to enterinformation associated with the obstetrics patient and/or to manipulatethe information displayed by the user interface implemented by theapparatus 100. Optionally still, the user input device 118 may be usedto enter contraction medication information conveying informationassociated to administration of contraction inducing medication to theobstetrics patient. The contraction medication information may indicatewhether contraction-inducing medication was administered and,optionally, the dosage of the contraction inducing medication that wasadministered. Since, typically, contraction-inducing medication isadministered continuously over time and not as a one shot dose, thecontraction medication information conveys the dosage of the contractioninducing medication administered over time. The user input device 118includes any one or a combination of the following: keyboard, pointingdevice, touch sensitive surface, keypad or speech recognition unit.Certain embodiments of the labour monitoring system 150 may omit theuser input device 118 without detracting from the spirit of theinvention.

Optionally, as shown in FIG. 1, the labour monitoring system 150 mayfurther include a fetal heart rate sensor 110. The fetal heart ratesensor 110 is for detecting a fetal heart rate of a fetus in-utero, alsoreferred to as a fetus in the womb. The fetal heart rate sensor 110samples the fetal heart rate at a certain pre-determined frequency togenerate the signal indicative of the fetal heart rate. Fetal heart ratesensors are well known in the art to which this invention pertains andany suitable sensor for detecting a fetal heart rate may be used withoutdetracting from the spirit of the invention and as such will not bedescribed further here.

Optionally still, the labour monitoring system 150 may include othersensors (not shown) for measuring labour progress and the fetus'tolerance to labour. Such sensors may include for example:

-   -   a sensor for measuring the maternal oxygen saturation    -   a sensor for measuring the fetal oxygen saturation    -   a sensor for measuring maternal blood pressure    -   a sensor for measuring and analysing the fetal electrocardiogram

Such sensors are not critical to the invention and therefore will not bedescribed further here.

The display unit 114 is in communication with the apparatus 100 andreceives a signal causing the display unit 114 to display a graphicaluser interface module implemented by apparatus 100. The display unit 114may be in the form of a display screen, a printer or any other suitabledevice for conveying to the physician or other health care professionaluterine contraction information associated to an obstetrics patient.

Optionally, the labour monitoring system 150 may further include a dataoutput module 130. The data output module 130 is in communication withthe apparatus 100 and is suitable for receiving signals generated by theapparatus 100. In a first specific example of implementation, the dataoutput module 130 includes an audio module for releasing audio signalson the basis of signals received from the apparatus 100. In a secondspecific example of implementation, the data output module 130 includesa data communication entity suitable for transmitting messages to remotedevices causing the latter to convey to a user of the labour monitoringsystem 150 information associated to labour progression. Examples ofremote devices include, without being limited to, PDAs, telephones,pagers and computing terminals.

A specific practical implementation of the labour monitoring system 150may implement the graphical user interface module for displaying uterinecontraction information as a stand-alone component or alternatively aspart of a more complete labour monitoring system including a pluralityof modules for monitoring various aspects of labour progression. Anexample of such a labour monitoring system is described in co-pendingU.S. patent application entitled “METHOD AND APPARATUS FOR DISPLAYINGLABOUR RELATED INFORMATION ASSOCIATED TO AN OBSTETRICS PATIENT” filed onMay 1, 2006 by Emily Hamilton and which was assigned Ser. No.11/416,281. The contents of the above application are incorporatedherein by reference.

Apparatus 100

A specific example of implementation of apparatus 100 will now bedescribed with reference to FIG. 2. The apparatus 100 includes an input202 (labelled as first input in the figure), a processing unit 206 andan output 208. The first input 202 is for receiving a contraction signalfrom the uterine activity sensor 120 (shown in FIG. 1) conveyinginformation related to occurrences of uterine contractions over time.The processing unit 206 is in communication with the first input 202 andimplements a graphical user interface module for displaying uterinecontraction information. The output 208 is for releasing a signal forcausing the display unit 114 (shown in FIG. 1) to display the graphicaluser interface module implemented by processing unit 206. Optionally, asshown in FIG. 2, the apparatus further includes a second input 216 forreceiving data from a user through input device 118 (shown in FIG. 1).Optionally still, the apparatus further includes a data interface 210for exchanging signals with a data output module 130 (shown in FIG. 1)for causing the latter to convey information associated to labourprogression to a user of the labour monitoring system 150 (shown in FIG.1).

Optionally, the apparatus further includes an additional input (notshown in the figures) for receiving fetal heart rate information. Thefetal heart rate information may including a fetal heart rate signal asgenerated by fetal heart rate sensor (110) or, alternatively, mayinclude information conveying a level of risk associated with the fetus,the level of risk being derived on the basis of a fetal heart ratesignal. Where the fetal heart rate information includes a fetal heartrate signal, the apparatus 100 is adapted for processing the signal todetermine a level of risk associated with the fetal heart rate signal.Any suitable method for assessing a level of risk on the basis of afetal heart rate signal may be used. For example, the level of risk maybe based on the frequency of the fetal heart rate, whether it is toohigh or too low for a certain period of time. Alternatively, the levelof risk may be based on other known methods. A non-limiting example of amethod for providing an indication of the level of risk is described inU.S. Pat. No. 7,113,819, entitled “Method and apparatus for monitoringthe condition of a fetus”, issued on Sep. 26, 2006 to E. Hamilton et al.and assigned to LMS Medical Systems Ltd. The contents of this documentare incorporated herein by reference. Other suitable methods forassessing a level of risk on the basis of a fetal heart rate signal maybe used without detracting from the spirit of the invention.

The graphical user interface module will now be described in greaterdetail.

The graphical user interface module receives the contraction signalconveying information related to uterine contractions over time anddisplays first and second information. The first information conveys arate of uterine contractions which is derived at least in part on thebasis of at least a portion of the contraction signal received at input202. The second information conveys a threshold rate of uterinecontractions. The threshold rate of uterine contractions definesboundaries of safe care and may be set in accordance best practices orin accordance with hospital/caregiver facility policy. Although thepresent description refers to a single threshold rate of uterinecontraction, it will be readily apparent that embodiments includingmultiple thresholds of uterine contractions, each threshold beingassociated with a respective degree of risk to the obstetrics patient,may be used in alternative implementations of the present invention.

The specific manner in which the information can be displayed to a userof the system 150 by the graphical user interface module may vary fromone implementation to the other without detracting from the spirit ofthe invention. Specific non-limiting examples of implementation of agraphical user interface module are shown in FIGS. 3, 4 a and 4 b.

A first specific example of implementation of the graphical userinterface module is shown in FIG. 3 of the drawings. In this specificimplementation, the first information includes a first tracing 504conveying rates of uterine contractions over time and the secondinformation includes a second tracing 502 conveying a threshold rate ofuterine contractions. The first tracing 504 and the second tracing 502are displayed in a same viewing window 500. The first tracing 504conveys a running average of the number of contraction events derivedfrom the contraction signal receiving at input 202 (shown in FIG. 2). Inthe non-limiting example shown in FIG. 3, the first tracing conveys thenumber of contraction events over the previous 10 minutes. The thresholdrate of uterine contractions illustrated by the second tracing 502 marksa boundary between uterine contraction rates considered to be withinsafe boundaries (contraction rates falling below the second tracing 502)and contraction rates considered as being associated to riskiersituations (contraction rates falling above the second tracing 502). Inthe example depicted, the second tracing 502 is depicted by a dottedline positioned along a contraction rate of 5 contractions/10 minutes,corresponding to a common definition of uterine hypercontractility. Itwill be readily appreciated that other suitable threshold rates ofuterine contractions may be used without detracting from the spirit ofthe invention. Advantageously, the implementation depicted in FIG. 3allows the clinical staff to readily observe the trend in contractionrates over time for a given obstetrics patient as conveyed by the firsttracing 504. The first and second tracings 504 502 displayed in a sameviewing window 500 allow to clinical staff to readily ascertain thecontraction rate and variations thereof with respect to the thresholdcontraction rate over an extended time period. This allows the clinicalstaff to have a more complete view of the history of the contractionrate since labour onset, or at least since the clinical staff wasmonitoring the labour. For example, this allows determining whether thecontraction rate is consistently above the threshold rate or whether itwas merely a temporary increase in contraction rate and was inducedeither through the administration of medication or other method. Also,in situations where the contraction rate exceeds the threshold rate, theimplementation depicted in FIG. 3 allows the clinical staff to observeby how much the contraction rate exceeds the threshold rate. This mayallow the clinical staff to ascertain more easily whether the excess isminor, indicating perhaps a low level risk, or whether it issignificant, requiring a quicker intervention.

A second specific example of implementation of the graphical userinterface module is shown in FIGS. 4a and 4b of the drawings. In thespecific implementation shown in FIG. 4a , the first informationincludes a first alphanumeric element 602 a conveying a rate of uterinecontractions associated to an obstetrics patient and the secondinformation includes a second alphanumeric element 604 conveying athreshold rate of uterine contractions. The first alphanumeric element602 a and the second alphanumeric element 604 are displayed concurrentlyin viewing window 600 a. In this specific implementation, the firstalphanumeric element 602 a reflects the current contraction rate derivedon the basis of a contraction signal received at input 202 (shown inFIG. 2). In the non-limiting example shown in FIG. 4a , the firstalphanumeric element 602 a conveys the number of contraction events overthe previous 10 minutes. The first alphanumeric element 602 a iscontinuously, or periodically, updated over time on the basis of thecontraction signal receiving at input 202 (shown in FIG. 2). Thethreshold rate of uterine contractions conveyed by the secondalphanumeric element 604 indicates the boundary between uterinecontraction rates considered to be within safe boundaries andcontraction rates considered as being associated to riskier situations.In the example depicted, the second alphanumeric element 604 conveys acontraction rate of 5 contractions/10 minutes, corresponding to a commondefinition of uterine hypercontractility. It will be readily appreciatedthat other suitable threshold rates of uterine contractions may be usedwithout detracting from the spirit of the invention.

Advantageously, the implementation depicted in FIGS. 4a and 4b allowsthe clinical staff to also readily appreciate whether current thecontraction rate is within the boundaries of safe care as conveyed bythe second alphanumeric element 604.

Optionally, as depicted in the specific examples shown in FIGS. 4a and4b , the graphical user interface module also displays an alphanumericindicator 610 a in the form of a rating for conveying to the user of thegraphical user interface module an indication of whether the currentcontraction rate is within the boundaries of safe care. In the exampledepicted in FIG. 4a , the first alphanumeric element 602 a conveys acontraction rate of 4 contractions/10 minutes which is below the 5contractions/10 minutes threshold conveyed by the second alphanumericelement 604. In this case the alphanumeric indicator 610 a indicates themessage “OK or SAFE” conveying that the current contraction rate iswithin an acceptable range. In FIG. 4b , the same example ofimplementation of the graphical user interface module as that shown inFIG. 4a is shown but with a different value of the current contractionrate. In this example, in the viewing window 600 b, the firstalphanumeric element 602 b conveys a contraction rate of 7contractions/10 minutes, which is above the 5 contractions/10 minutesthreshold conveyed by the second alphanumeric element 604. In this casethe alphanumeric indicator 610 b indicates the message “ELEVATED RISK”conveying that the current contraction rate is not within an acceptablerange. In alternative examples of implementation, the alphanumericindicator 610 b may be adapted for displaying graded risk levels such asfor example “mildly elevated”, “moderately elevated” and “criticallyelevated” for example.

Alarm Events

The graphical user interface module is adapted for selectively causingan alarm event based at least in part on a rate of uterine contractionsand the threshold rate of uterine contractions. In a specific example ofimplementation, the alarm event is for alerting the clinical staffmaking use of the system of an occurrence of a potentially problematicsituation during labour associated to the occurrence of contractions.The alarm event may be triggered in a number of situations and may bebased on rates of uterine contractions and the threshold rate of uterinecontractions and optionally on the basis of either one or both ofcontraction medication information and fetal heart rate information.Examples of the manners in which an alarm event may be selectivelycaused will be described later on in the specification.

An alarm event, in accordance with a specific example of implementationof the invention, may include one or more components for communicatinginformation to a user of the graphical user interface module.

In a first specific implementation, the alarm event includes displayinga visual indicator to convey to a user of the graphical user interfacemodule an occurrence of a potentially problematic situation duringlabour. The visual indicator may be displayed as part of the graphicaluser interface module or in a separate display at a remote location. Anysuitable type of visual indicator may be used. Examples of visualindicators that may be used include, without being limited to:

-   -   Variations in color. For example, a color scheme may be        established whereby certain colors are associated with varying        levels of risk. Portions of the graphical user interface may        turn a certain color associated with a high level of risk when,        for example, the rate of uterine contractions falls outside a        limit set by the threshold rate of uterine contractions. In the        non-limiting example depicted in FIG. 3, the portions of the        first tracing 504 exceeding the threshold contraction rate        (illustrated by reference numeral 508 in the figure) are        displayed in a different colour or colour intensity that the        remaining portions of the first tracing 504. Alternatively, the        entire display window or a portion of the window may be        displayed may turn a certain color associated with a high level        of risk based at least in part on a rate of uterine contractions        conveyed by the first information and the threshold rate of        uterine contractions. A non-limiting example of a color scheme        is green=normal; yellow: intermediate risk level; red: high        level of risk however any suitable color scheme may be used.    -   Variation in display intensity of the viewing window. For        example, flashing or blinking of the viewing window may be used        as a visual indicator to draw the attention of the user;    -   Variation in the size or position of the viewing window. For        example, the viewing window may be made to appear more        prominently on the display unit or at a location that is more        likely to draw the attention of the clinical staff;    -   Displaying a message prompting/alerting the clinical staff. For        example, in FIG. 4b , an alphanumeric message 610 is displayed        as “ELEVATED RISK” to convey that the current contraction rate        conveyed by the first alphanumeric element 602 b has exceeded        the threshold rate of uterine contractions conveyed by the        second alphanumeric element 604. In this example, when the        current contraction rate falls below the threshold rate of        uterine contractions, either no message may be displayed or a        message conveying that the current contraction rate is within        the limit set by the threshold rate of uterine contractions as        shown in FIG. 4 a.

In a second specific implementation, the alarm event includes causing anaudio signal to be issued, alone or in combination with a visualindicator, to draw attention of a user of the graphical user interfacemodule. In this second specific implementation, the processing unit 206(shown in FIG. 2) releases a signal at the data interface 210 forcausing an audio unit (not shown in the figures) to issue an audiosignal. The audio unit may be connected directly to the data interface210 through either a wire-line link or a wireless link. Alternatively,the audio unit may be in communication with the data interface 210 overa network. Alternatively still, the audio unit may be an integral partof apparatus 100.

In a third specific implementation, the alarm event includes causing amessage signal to be transmitted to a remote device. The remote devicemay be, for example, a PDA, telephone, pager or a remote computingterminal. Other suitable types of remote devices may also be envisagedin other specific implementations of the present invention. In thisthird specific implementation, the processing unit 206 (shown in FIG. 2)releases a signal at the data interface 210 for causing a message signalto be transmitted to the remote device. The remote device may beconnected directly to the data interface 210 though either a wire-linelink or a wireless link. Alternative, the remote device may be incommunication with the data interface 210 over a network. In a firstpractical example of interaction, the remote device is a PDA assigned toa doctor responsible for overseeing deliveries in a hospital. At leastin part on a rate of uterine contractions conveyed by the firstinformation and the threshold rate of uterine contractions, thegraphical user interface module selectively sends a message through thedata interface 210 and over a network to the PDA of the doctor to alertthat doctor. The message may include any suitable useful informationincluding, but not limited to, the name of the obstetrics patient, thelocation of the patient, the contraction rate, contraction medicationinformation, fetal heart rate information, labour progressioninformation (duration of labour, time since admission to hospital) andmedical history. Optionally, the message may also enable the PDA of thedoctor to display all or part of the user interface module described inthe present application. For example, the message may enable the PDA ofthe doctor to display a user interface of the type depicted in FIGS. 3,4 a and 4 b. Alternatively, the message may only indicate that a certainpatient requires closer monitoring of her contraction rate. The specificformat of the message is not critical to the invention and as such willnot be discussed further here.

In second practical example of interaction, the remote device is aremote computing terminal located at a centralised nursing station in ahospital birthing centre. At least in part on a rate of uterinecontractions conveyed by the first information and the threshold rate ofuterine contractions, the graphical user interface module selectivelycauses a message to be sent to the remote computing terminal.Advantageously, by allowing a message to be transmitted to a remotedevice, the clinical staff need not be located near the patient or inproximity to the patient to be alerted to potentially problematicsituations. In addition, the clinical staff need not be expresslymonitoring the progression of the contraction rate to be alerted to anunsafe condition for the contraction rate.

The Process

An exemplary embodiment of the process implemented by the graphical userinterface will now be described with reference to FIGS. 6a and 6 b.

With reference to FIG. 6a , at step 300, the contraction signal isreceived by the graphical user interface module.

At step 302, the graphical user interface module computes a contractionrate on the basis of the contraction signal received at step 300.

The specific manner in which the contraction rate is computed willdepend on the format of the contraction signal. In a first specificexample, the contraction signal is a continuous signal conveying theintensity of the uterine contractions over time. A non-limitinggraphical representation of such a continuous signal is depicted in FIG.7a for the purpose of illustration. In such an implementation, thegraphical user interface module is operative for processing thecontraction signal to detect the occurrence of contraction events in thecontraction signal. Any suitable pattern recognition technique may beused for identifying the occurrence of contraction events. Suchtechniques are well known in the art of signal processing and as suchwill not be described further here. Once the occurrence of contractionevents has been detected, the contraction rate can be computed.

In a second specific example, the contraction signal received at input202 is comprised of unitary signal events where a signal event isgenerated when a contraction event is detected. A non-limiting graphicalrepresentation of such a continuous signal is depicted in FIG. 7b forthe purpose of illustration. In such an implementation, patternrecognition techniques are not required since the presence ofcontraction events is already conveyed by the contraction signal.

In a specific implementation, the graphical user interface modulecomputes a rate of contraction events in the contraction signal for acertain time segment. The rate of contraction events in the contractionsignal may be computed in a number of suitable manners.

In a specific example, a current contraction rate is equal to the numberof contraction events detected in the contraction signal over the lasttime duration T. The duration T may be any suitable time duration. In anon-limiting example, the duration T is 10-15 minutes and the currentcontraction rate is the number of contraction events in the contractionsignal that occurred over the previous 10-15 minutes. Most clinicalguidelines describe the desirable contraction frequency based on anobservation period of 10-15 minutes. It will be readily apparent to theperson skilled in the art that the time duration T may have a durationdifferent than 10-15 minutes. Moreover, the time duration T may be aconfigurable parameter of the graphical user interface moduleimplemented by processing unit 206 without detracting from the spirit ofthe invention. Typically, the duration T will be selected to be a timeduration sufficiently long so that a few contraction events are likelyto occur during active labour but sufficiently short so that thecontraction rate for a given time duration T is representative of theprogression of the contraction rate during active labour. It will bereadily apparent to the person skilled in the art that a very lengthytime duration, let us say 3 hours, does not provide useful informationas to whether the contraction rate is within reasonable boundaries.Similarly, a very short time duration, let us say 2 minutes, also doesnot provide any useful information as to whether the contraction rate iswithin reasonable boundaries.

It will be readily apparent to the person skilled in the art, in lightof the present description, that other well-known techniques forcomputing a contraction rate on the basis of a contraction signal may beused without detracting from the spirit of the invention.

At step 304, the graphical user interface module implemented by theprocessing unit 206 displays first information conveying the rate ofuterine contractions derived at step 302. At step 306, the graphicaluser interface module implemented by the processing unit 206 displaysconcurrently with the first information, second information conveying athreshold rate of uterine contractions. Specific non-limiting examplesof formats for the first information and second information weredescribed with reference to FIGS. 3, 4 a and 4 b of the drawings.

At step 308, the graphical user interface module determines, at least inpart on the basis of the computed contraction rate and the thresholdcontraction rate, whether an alarm event should be caused.

As will become apparent to the person skilled in the art in light of thepresent specification, different conditions may bring the graphical userinterface module to cause an alarm event.

In a first specific example of implementation, an alarm event istriggered depending on the specific circumstances conveyed by thecomputed contraction rate and the threshold contraction rate alone.

In a second specific example of implementation, an alarm event istriggered depending on the specific circumstances conveyed by thecomputed contraction rate and the threshold contraction rate incombination with other factors. Such other factors may include, withoutbeing limited to, contraction medication information and fetal heartrate information.

In either one of the above described specific examples ofimplementation, the conditions for causing an alarm event may bedetermined on the basis of a hospital policy or in accordance with bestrecognised practices in health care.

In a specific example of implementation, step 308 shown in FIG. 6aincludes multiple sub-steps for determining whether an alarm eventshould be caused. FIG. 6b shows a non-limiting example of implementationof process step 308.

As depicted, at step 350 the graphical user interface module determineswhether the computed contraction rate exceeds the limit set by thresholdcontraction rate. If step 350 is answered in the negative and thecomputed contraction rate does not exceed the limit set by thresholdcontraction rate, step 308 determines that no alarm should be caused andthe graphical user interface proceeds to step 300.

If step 350 is answered in the affirmative and the computed contractionrate exceeds the limit set by threshold contraction rate, the graphicaluser interface proceeds to step 352 where an additional condition istested.

At step 352 the graphical user interface module determines whether thecomputed contraction rate has exceeded the limit set by the thresholdcontraction rate for a time duration exceeding a predetermined timeduration. This step 352 allows testing whether the excess of thecontraction rate is merely transient of whether it is persistent. Thepredetermined time duration may be established on the basis of ahospital policy or, alternatively, on the basis of other clinicalguidelines.

If step 352 is answered in the affirmative and the computed contractionrate exceeds the limit set by threshold contraction rate for a durationof time exceeding the predetermined time duration indicating that theexcess of the contraction rate is persistent, step 308 determines thatan alarm event should be caused and the graphical user interfaceproceeds to step 310.

If step 352 is answered in the negative and the computed contractionrate has not exceeded the limit set by threshold contraction rate for aduration of time exceeding the predetermined time duration indicatingthat the excess of the contraction rate may be transient, the graphicaluser interface module proceed to step 356 where an additional conditionis tested.

At step 356 the graphical user interface module determines whether thecontraction medication information indicates that contraction inducingmedication was given to the obstetrics patient. Optionally, step 356 mayalso evaluate the level (or dosage) of contraction inducing medicationif any was changed and use that information in effecting the decisionstep 356.

If step 356 is answered in the affirmative and the contractionmedication information indicates that contraction inducing medicationwas given to the obstetrics patient, step 308 determines that an alarmevent should be caused and the graphical user interface proceeds to step310.

If step 356 is answered in the negative and the contraction medicationinformation indicates that contraction inducing medication was not givento the obstetrics patient, the graphical user interface module proceedto step 358 where an additional condition is tested.

At step 358 the graphical user interface module determines whether thefetal heart rate information available indicates a problematic risklevel associated with the baby's well-being. The fetal heart rateinformation may include a fetal heart rate signal or, alternatively, mayinclude information conveying a level of risk associated with the fetus,the level of risk being derived on the basis of a fetal heart ratesignal. In a specific example of implementation, the fetal heart rateinformation includes a fetal heart rate signal and is received from thefetal heart rate sensor 110 (shown in FIG. 1). Where the fetal heartrate information includes a fetal heart rate signal, step 358 includesprocessing the signal to determine a level of risk associated with thefetal heart rate signal. Any suitable method for assessing a level ofrisk on the basis of a fetal heart rate signal may be used. For example,the level of risk may be based on the frequency of the fetal heart rate,whether it is too high or too low for a certain period of time.Alternatively, the level of risk may be based on other suitable knownmethods. A non-limiting example of a method for providing an indicationof the level of risk is described in U.S. Pat. No. 7,113,819, entitled“Method and apparatus for monitoring the condition of a fetus”, issuedon Sep. 26, 2006 to E. Hamilton et al. and assigned to LMS MedicalSystems Ltd. The contents of this document are incorporated herein byreference. Other suitable methods for assessing a level of risk on thebasis of a fetal heart rate signal may be used without detracting fromthe spirit of the invention.

If step 358 is answered in the affirmative and the fetal heart rateinformation indicates a problematic risk level associated with thebaby's well-being, step 308 determines that an alarm event should becaused and the graphical user interface proceeds to step 310.

If step 358 is answered in the negative and the fetal heart rateinformation does no indicates a problematic risk level associated withthe baby's well-being, step 308 determines that no alarm should becaused and the graphical user interface proceeds to step 300.

In the specific example of implementation shown in FIG. 6b , steps 352356 and 358 are optional steps which may be included or omitted fromspecific implementations of the present invention. In addition, it willbe appreciated in light of the present specification that other suitablemanners of determining whether an alarm event should be caused on thebasis of the computed contraction rate and the threshold contractionrate may be used without detracting from the spirit of the invention. Assuch, it should be understood that the example depicted in FIG. 6b waspresented for the purpose of illustration only.

Returning now to FIG. 6a , if step 308 determines that an alarm eventshould be caused, the graphical user interface module proceeds to step310 where an alarm event is triggered. Examples of alarm events weredescribed previously in the specification. The graphical user interfacemodule then returns to step 300 where the next segment of thecontraction signal is received and subsequently processed.

If step 308 determines that no alarm event should be caused, thegraphical user interface module returns to step 300 where the nextsegment of the contraction signal is received and subsequentlyprocessed.

As can be observed, the process illustrated in FIG. 6a is an iterativeprocess whereby steps 300 to 308 (and selectively step 310 when an alarmevent is caused to occur) are repeated as time progresses and as newsegments of the contraction signal are received by the apparatus. Overtime, the graphical user interface module processes the contractionsignal to derive a set of contraction rate data elements, where eachcontraction rate data element in the set of contraction rate dataelements is associated to a segment of the contraction signal. In anon-limiting example, the graphical user interface module computes arunning average of contractions in the contraction signal to derive theset of contraction rate data elements.

Although the exemplary embodiment of the process implemented by thegraphical user interface described with reference to FIGS. 6a and 6bmade reference to a single alarm event presented in box 310, it will beappreciated that different types of alarm events may be caused by thegraphical user interface. More specifically, different circumstancesconveyed by the computed contraction rate, contraction medicationinformation, fetal heart rate information and optionally otherconditions may be associated to respective types of alarm events.Therefore, although the specification described causing a given alarmevent, it should be understood that different types of alarm events maybe caused and that the type of alarm event caused may be conditioned atleast in part on the basis of the circumstances conveyed by the computedcontraction rate, (optionally) contraction medication information,(optionally) fetal heart rate information and optionally otherconditions

Variant

As a variant, the graphical user interface module is adapted fordisplaying, concurrently with the first information conveying a rate ofuterine contractions and the second information conveying a thresholdrate of uterine contractions, additional information elements related tolabour progression.

FIG. 5 of the drawings depicts a non-limiting example of implementationof a display generated by the graphical user interface module inaccordance with this variant.

As shown, the graphical user interface module displays a first viewingwindow 570 including a first tracing 574 conveying rates of uterinecontractions over time and a second tracing 572 conveying a thresholdrate of uterine contractions. The graphical user interface module alsodisplays a second viewing window 558 including a tracing 582 conveying auterine contraction pattern over time (TOCO tracing) and a tracing 584conveying a fetal heart rate pattern over time. The tracing 582conveying a uterine contraction pattern over time is derived on thebasis of the contraction signal received from the uterine activitysensor 120 (shown in FIG. 1). The tracing 584 conveying a fetal heartrate pattern over time is derived on the basis of the fetal heart ratesignal received from the fetal heart rate sensor 110 (also shown in FIG.1). Preferably, the first viewing window 570 and second viewing window558 are time-aligned with one another on the display. In addition, itwill be appreciated that either one of the tracings 584 and 582 may beomitted from the second viewing window 558 or that these tracings 584and 582 may be displayed in separate viewing windows without detractingfrom the spirit of the invention.

Advantageously, the display of the tracing 584 conveying a fetal heartrate pattern over time allows the users of the system to view arepresentation of the baby's response to the contraction events.

The display of the tracing 582 conveying a uterine contraction patternover time allows the users of the system to view a representation of theoriginal contraction signal and to assess whether the tracing 574conveying rates of uterine contractions over time accurately reflectsthe rate of contractions in the original contraction signal. This isparticularly useful when the contraction signal generated by the uterineactivity sensor part of the electronic fetal monitor 110 (shown inFIG. 1) is a continuous contraction signal (as opposed to a unitarycontraction signal) since pattern recognition techniques must be used onsuch a continuous signal to determine the occurrence of a contractionevent. These pattern recognition techniques may erroneously detect anoccurrence of a contraction event or may fail to detect an occurrence ofa contraction event. Therefore, by presenting the user with the tracing582 conveying a uterine contraction pattern over time, that user mayadjust his/her assessment of the first tracing 574.

In the embodiment depicted, the graphical user interface module alsodisplays a control 556 allowing a user to select a portion of thetracings in the first viewing window 570 and/or the second viewingwindow 558. The user is enabled to manipulate the control 556 byproviding signals using user input device 118 (shown in FIG. 1).

In a specific implementation, the control 556 includes a selection boxhaving a transparent portion superposed upon the first viewing window570 and the second viewing window 558. The portions of the tracingsviewable through the transparent portion correspond to the selectedportions. The control 556 allows the user to displace and modify thesize of the selection box to select a portion of the tracings. Othermanners in which portions of a labour progression signal may be selectedare described in U.S. Pat. No. 6,907,284 issued to E. Hamilton et al. onJun. 14, 2005. The contents of this document are incorporated herein byreference.

In the embodiment depicted, the graphical user interface module alsodisplays a third viewing window 550 including a tracing 552 conveying afetal heart rate pattern over time and a tracing 554 conveying a uterinecontraction pattern over time (TOCO tracing). The tracing 552 in thethird viewing window 550 conveying a fetal heart rate pattern over timecorresponds to the selected portion of the tracing 584 in the secondviewing window 558 and is a zoomed-in view of that selected portion. Thetracing 554 in the third viewing window 550 conveying a conveying auterine contraction pattern over time (TOCO tracing) corresponds to theselected portion of the tracing 582 in the second viewing window 558 andis a zoomed-in view of that selected portion. In addition, it will beappreciated that either one of the tracings 552 and 554 may be omittedfrom the third viewing window 550 or that these tracings 552 and 554 maybe displayed in separate viewing windows without detracting from thespirit of the invention.

Advantageously, by displaying zoomed-in views of the selected portionsof the tracings 582 and 584, a user will be able to better viewresponses of the fetal heart rate to individual contraction events(amount of variability size and type of deceleration) and will be ableto better assess the intensity and duration of a given contractionevent.

In the embodiment depicted, the graphical user interface module alsodisplays a fourth viewing window 560 including a tracing 561 conveyinginformation associated to administration of contraction inducingmedication to the obstetrics patient. The tracing 561 is derived on thebasis of contraction medication information received by apparatus 100(shown in FIG. 1). The contraction medication information may indicatewhether contraction-inducing medication was administered and,optionally, a dosage of the contraction inducing medicationadministered. Since, typically, contraction inducing medication isadministered continuously over time and not as a one shot dose, thecontraction medication information when conveying a dosage of thecontraction inducing medication administered may convey such dosage overtime. In a first specific example of implementation, the contractionmedication information is provided by the clinical staff usinguser-input device 118. In this first implementation, the clinical staffpreferably entered the level (or dosage) of the contraction-inducingmedication administered and updates that information when the dosage ismodified. In a second specific example of implementation, thecontraction medication information is provided automatically by adevice, typically in the form of an electronic pump, designed to measurethe dosage of medication provided to the obstetrics patient and providethat information over time to apparatus 100. In the embodiment depictedin FIG. 5, the tracing 561 shows the level of medication administeredover time to stimulate contractions. It will be appreciated by theperson skilled in the art of obstetrics that the tracing 561 is notrepresentative of an actual (real life) situation and that the levels ofmedication conveyed by tracing 561 are presented here for the purpose ofillustration only.

Advantageously, the tracing 561 allows the clinical staff to readilyview whether contraction inducing medication was administered to theobstetrics patient being monitored (and optionally the amount ofcontraction inducing medication which was administered).

Specific Physical Implementation

Those skilled in the art should appreciate that in some embodiments ofthe invention, all or part of the functionality previously describedherein with respect to the apparatus for implementing a user interfacefor displaying uterine contraction information may be implemented aspre-programmed hardware or firmware elements (e.g., application specificintegrated circuits (ASICs), electrically erasable programmableread-only memories (EEPROMs), etc.), or other related components.

In other embodiments of the invention, all or part of the functionalitypreviously described herein with respect to the apparatus forimplementing a user interface for displaying uterine contractioninformation may be implemented as software consisting of a series ofinstructions for execution by a computing unit. The series ofinstructions could be stored on a medium which is fixed, tangible andreadable directly by the computing unit, (e.g., removable diskette,CD-ROM, ROM, PROM, EPROM or fixed disk), or the instructions could bestored remotely but transmittable to the computing unit via a modem orother interface device (e.g., a communications adapter) connected to anetwork over a transmission medium. The transmission medium may beeither a tangible medium (e.g., optical or analog communications lines)or a medium implemented using wireless techniques (e.g., microwave,infrared or other transmission schemes).

The apparatus implementing a user interface for displaying uterinecontraction information may be configured as a computing unit of thetype depicted in FIG. 8, including a processing unit 702 and a memory704 connected by a communication bus 708. The memory 704 includes data710 and program instructions 706. In a specific example ofimplementation, the data 710 stored in memory 704 includes one or morethreshold contraction rates. The processing unit 702 is adapted toprocess the data 710 and the program instructions 706 in order toimplement the functional blocks described in the specification anddepicted in the drawings. In a non-limiting implementation, the programinstructions 706 implement the functionality of processing unit 206described above. The computing unit 702 may also comprise a number ofinterfaces 712 714 716 for receiving or sending data elements toexternal devices. For example, interface 712 is used for receiving datastreams indicative of uterine activity and interface 714 is used forreceiving a control signals and/or information from the user. Interface716 is for releasing a signal causing a display unit to display the userinterface generated by the program instructions 706. Optionally, thecomputing unit 702 may include additional interfaces (not shown) forreceiving information from additional sensors such as, for example, afetal heart rate sensor.

It will be appreciated that the system for implementing a user interfacefor displaying uterine contraction information may also be of adistributed nature where the contraction signal is collected at onelocation by a uterine activity sensor and transmitted over a network toa server unit implementing the graphical user interface. The server unitmay then transmit a signal for causing a display unit to display thegraphical user interface. The display unit may be located in the samelocation as the uterine activity sensor, in the same location as theserver unit or in yet another location. FIG. 10 illustrates anetwork-based client-server system 900 for displaying uterinecontraction information. The client-server system 900 includes aplurality of client systems 912 914 916 918 connected to a server system910 through network 920. The communication links 950 between the clientsystems 912 914 916 918 and the server system 910 can be metallicconductors, optical fibers or wireless, without departing from thespirit of the invention. The network 920 may be any suitable networkincluding but not limited to a global public network such as theIntranet, a private network and a wireless network. The server 910 maybe adapted to process and issue signals to display multiple heart ratesignals originating from multiple sensors 926 928 concurrently usingsuitable methods known in the computer related arts.

The server system 910 includes a program element 960 for execution by aCPU. Program element 960 implements similar functionality as programinstructions 706 (shown in FIG. 8) and includes the necessary networkingfunctionality to allow the server system 910 to communicate with theclient systems 912 914 916 918 over network 920. In a non-limitingimplementation, program element 960 includes a number of program elementcomponents, each program element components implementing a respectiveportion of the functionality of the user interface for displayinguterine contraction information.

FIG. 9 shows a non-limiting example of the architecture of programelement 960 at the server system. As shown, the program element 960includes three program element components:

-   -   1. the first program element component 800 is executed on server        system 910 and is for receiving a contraction signal conveying        information related to occurrences of uterine contractions over        time;    -   2. the second program element component 802 is executed on        server system 910 and is for sending messages to a client        system, say client system 914, for causing client system 914 to:        -   display first information conveying a rate of uterine            contractions, the first information being derived at least            in part on the basis of at least a portion of the            contraction signal; and        -   display, concurrently with the first information, second            information conveying a threshold rate of uterine            contractions;    -   3. the third program element component 804 is executed on server        system 910 and is for selectively sending messages to client        system 914 for causing an alarm event based at least in part on        a rate of uterine contractions conveyed by said first        information and the threshold rate of uterine contractions.        Alternatively, the third program element component 804 is        executed on server system 910 and is for selectively sending        messages to a client system distinct from the client system 914        for causing an alarm event at the distinct client system. The        messages for causing an alarm event may include alarm program        elements for execution at the client system, the alarm program        elements implementing the alarm events when executed at the        client system. Alternatively, alarm program elements for        implementing the alarm events are stored at the client system        and the messages for causing an alarm event transmitted from the        server system 910 include instructions for causing the alarm        program elements at the client system to be executed.

Those skilled in the art should further appreciate that the programinstructions 706 and 960 may be written in a number of programminglanguages for use with many computer architectures or operating systems.For example, some embodiments may be implemented in a proceduralprogramming language (e.g., “C”) or an object oriented programminglanguage (e.g., “C++” or “JAVA”).

Although the present invention has been described in considerable detailwith reference to certain preferred embodiments thereof, variations andrefinements are possible without departing from the spirit of theinvention. Therefore, the scope of the invention should be limited onlyby the appended claims and their equivalents.

The invention claimed is:
 1. A non-transitory computer readable storagemedium storing a program element suitable for execution by a processor,said program element implementing a process for monitoring an obstetricspatient during labour, said processor when executing said programelement being configured for: (a) receiving a contraction signalassociated with the obstetrics patient, the contraction signal conveyinginformation related to uterine contractions over time; (b) processingthe contraction signal to derive first information conveying rates ofuterine contractions over time; (c) causing said first information to bedisplayed in a viewing window on a display device; (d) derivinginformation conveying if an anomalous contraction rate has persisted fora prolonged period of time, said information being derived at least inpart by determining if the rates of uterine contractions conveyed bysaid first information have fallen outside a limit set by a thresholdrate of uterine contractions for a time duration exceeding apredetermined time duration; (e) receiving contraction medicationinformation conveying whether contraction inducing medication wasadministered to the obstetrics patient; (f) selectively causing an alarmevent at least in part based on: (i) the information conveying if theanomalous contraction rate has persisted for the prolonged period oftime; and (ii) said contraction medication information.
 2. Anon-transitory computer readable storage medium as defined in claim 1,said processor when executing said program element being configured for:(a) receiving fetal heart rate information; (b) selectively causing thealarm event based at least in part: (i) on the information conveying ifthe anomalous contraction rate has persisted for the prolonged period oftime; (ii) on said contraction medication information; and (iii) on saidfetal heart rate information.
 3. A non-transitory computer readablestorage medium as defined in claim 1, wherein said first informationincludes a first tracing conveying the rates of uterine contractionsover time; and wherein said processor when executing said programelement is operative for causing said first tracing to be displayed inthe viewing window concurrently with a second tracing, said secondtracing conveying the threshold rate of uterine contractions.
 4. Anon-transitory computer readable storage medium as described in claim 1,wherein said alarm event includes displaying a visual indicator.
 5. Anon-transitory computer readable storage medium as described in claim 1,wherein said alarm event includes causing an audio signal to be issued.6. A non-transitory computer readable storage medium as described inclaim 1, wherein said alarm event includes causing a message signal tobe transmitted to a remote device.
 7. A non-transitory computer readablestorage medium as described in claim 6, wherein the remote device is adevice selected from the set consisting of a PDA, telephone, pager andcomputing terminal.
 8. A non-transitory computer readable storage mediumas described in claim 6, wherein said alarm event includes causing amessage signal to be transmitted over a network to the remote device. 9.An apparatus for monitoring an obstetrics patient during labour, saidapparatus comprising: (a) an input for receiving a contraction signalassociated with the obstetrics patient, the contraction signal conveyinginformation related to occurrences of uterine contractions over time;(b) a processing unit in communication with said input, said processingunit being programmed for: (i) processing the contraction signal toderive first information conveying rates of uterine contractions overtime; (ii) displaying said first information in a viewing window on adisplay device; (iii) deriving information conveying if an anomalouscontraction rate has persisted for a prolonged period of time, saidinformation being derived at least in part by determining if the ratesof uterine contractions conveyed by said first information have fallenoutside a limit set by a threshold rate of uterine contractions for atime duration exceeding a predetermined time duration; (iv) receivingcontraction medication information conveying whether contractioninducing medication was administered to the obstetrics patient; (v)selectively causing an alarm event at least in part based on: (1) theinformation conveying if the anomalous contraction rate has persistedfor the prolonged period of time; and (2) the contraction medicationinformation.
 10. An apparatus as defined in claim 9, said processingunit being programmed for: (a) receiving fetal heart rate information;(b) selectively causing the alarm event based at least in part: (i) onthe information conveying if the anomalous contraction rate haspersisted for the prolonged period of time; (ii) on said contractionmedication information; and (iii) on said fetal heart rate information.11. An apparatus as defined in claim 9, wherein: (a) said firstinformation includes a first tracing conveying rates of uterinecontractions over time; (b) said processing unit is programmed fordisplaying said first tracing in the viewing window concurrently with asecond tracing, said second tracing conveying the threshold rate ofuterine contractions.
 12. An apparatus as described in claim 9, whereinsaid alarm event includes displaying a visual indicator.
 13. Anapparatus as described in claim 9, wherein said alarm event includescausing an audio signal to be issued.
 14. An apparatus as described inclaim 9, wherein said alarm event includes causing a message signal tobe transmitted to a remote device.
 15. An apparatus as described inclaim 14, wherein the remote device is a device selected from the setconsisting of a PDA, telephone, pager and computing terminal.
 16. Anapparatus as described in claim 14, wherein said alarm event includescausing a message signal to be transmitted over a network to the remotedevice.
 17. A method for monitoring an obstetrics patient during labour,said method comprising: (a) receiving at an input of a computingapparatus having a processor a contraction signal associated with theobstetrics patient, said contraction signal conveying informationrelated to occurrences of uterine contractions over time; (b) using theprocessor of the computing apparatus: (i) processing the contractionsignal to derive first information conveying rates of uterinecontractions over time; (ii) causing said first information to bedisplayed in a viewing window on a display device; (iii) derivinginformation conveying if an anomalous contraction rate has persisted fora prolonged period of time, said information being derived at least inpart by determining if the rates of uterine contractions conveyed bysaid first information have fallen outside a limit set by a thresholdrate of uterine contractions for a time duration exceeding apredetermined time duration; (iv) receiving contraction medicationinformation conveying whether contraction inducing medication wasadministered to the obstetrics patient; (v) selectively causing an alarmevent at least in part based on: (1) the information conveying if theanomalous contraction rate has persisted for the prolonged period oftime; and (2) said contraction medication information.
 18. A method asdefined in claim 17, said method comprising: (a) receiving fetal heartrate information; (b) selectively causing the alarm event based at leastin part: (i) on the information conveying if the anomalous contractionrate has persisted for the prolonged period of time; and (ii) on saidcontraction medication information; and (iii) on said fetal heart rateinformation.
 19. A method as defined in claim 17, wherein: (a) saidfirst information includes a first tracing conveying rates of uterinecontractions over time; (b) said method comprising causing said firsttracing to be displayed in the viewing window concurrently with a secondtracing, said second tracing conveying the threshold rate of uterinecontractions.
 20. A method as described in claim 17, wherein said alarmevent includes displaying a visual indicator.
 21. A method as describedin claim 17, wherein said alarm event includes causing an audio signalto be issued.
 22. A method as described in claim 17, wherein said alarmevent includes causing a message signal to be transmitted to a remotedevice.
 23. A method as described in claim 22, wherein the remote deviceis a device selected from the set consisting of a PDA, telephone, pagerand computing terminal.
 24. A method as described in claim 22, whereinsaid alarm event includes causing a message signal to be transmittedover a network to the remote device.